Features of echocardiographic assessment on transcatheter aortic valve implantation multiple stages

G. Yemets, O. Telehuzova, G. Mankovsky, A. Maksymenko, Y. Marushko, A. Dovhaliuk, A. Sokol, I. Yemets
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Abstract

The aim – to systematize information on key features of echocardiographic evaluation of transcatheter aortic valve implantation (TAVI) procedure stages and their effectiveness in cardiac surgery, in patients with severe aortic valve stenosis.Materials and methods. We initiated a single-center clinical study to evaluate the XPand device and initial analysis of the primary results was performed. Patients met the inclusion criteria underwent a full range of examinations and TAVI procedures using the XPand device. The key parameters for echocardiographic examination in TAVI, which influence the formation of further procedure strategy, have been determined for the cardiac surgeon.Results and discussion. Based on the determined echocardiographic parameters, we obtained the primary outcomes of TAVI XPand in patients (n=7), the result of implantation was good. Minimal paravalvular insufficiency absence was found in 71.5 % of patients and minimal insufficiency in 14,5 %. In one patient to moderate insufficiency was observed. There was a statistically significant improvement in the ejection fraction (p<0.05) and a decrease in the mean gradient at the aortic valve (p<0.01).Conclusions. Echocardiographic parameters at all TAVI stages in patients over 75 years allow to control the implementation of the procedure and to improve the immediate post procedural outcome. The first experience of using the novel device for transcatheter implantation of the XPand aortic valve prosthesis confirms its effectiveness and safety in elderly patients with severe aortic stenosis.
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经导管主动脉瓣置入术多期超声心动图评价特点
目的:对经导管主动脉瓣置入术(TAVI)阶段超声心动图评价的关键特征及其在心脏外科手术中严重主动脉瓣狭窄患者的有效性进行系统化的信息。材料和方法。我们启动了一项单中心临床研究来评估XPand装置,并对主要结果进行了初步分析。符合纳入标准的患者使用XPand设备进行了全面检查和TAVI手术。为心脏外科医生确定了超声心动图检查的关键参数,这些参数会影响TAVI进一步手术策略的形成。结果和讨论。根据确定的超声心动图参数,我们获得TAVI XPand患者(n=7)的主要结局,植入效果良好。71.5%的患者有轻微瓣旁功能不全,14.5%的患者有轻微瓣旁功能不全。1例患者观察到中度肾功能不全。两组患者的射血分数改善有统计学意义(p<0.05),主动脉瓣平均梯度降低有统计学意义(p<0.01)。75岁以上TAVI患者所有阶段的超声心动图参数可以控制手术的实施并改善手术后的即时结果。首次应用该新型装置经导管植入XPand主动脉瓣假体,证实了其在老年重度主动脉瓣狭窄患者中的有效性和安全性。
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